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Predictors of Pulmonary Infarction.

Massimo Miniati1, Matteo Bottai, Cesario Ciccotosto

  • 1From the Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (MM); Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (MB); Department of Radiology, "S. Donato" Hospital, Arezzo (CC); Department of Experimental Medicine, 2nd University of Naples, Naples (LR); and Institute of Clinical Physiology, National Research Council of Italy, and "Gabriele Monasterio" Foundation, Pisa, Italy (SM).

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Pulmonary infarction occurs in nearly one-third of patients with acute pulmonary embolism (PE). Younger, healthier individuals, particularly those who are taller or smoke, face a higher risk of infarction.

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Area of Science:

  • Cardiology
  • Radiology
  • Pulmonology

Background:

  • Pulmonary infarction in acute pulmonary embolism (PE) was traditionally associated with compromised cardiac function.
  • The relationship between infarction and patient demographics/comorbidities requires further elucidation.

Purpose of the Study:

  • To determine the prevalence of pulmonary infarction in acute PE patients.
  • To investigate the association between pulmonary infarction and age, height, BMI, smoking, clot burden, and comorbidities.

Main Methods:

  • Prospective study of 335 patients with acute PE diagnosed via CT angiography.
  • Pulmonary infarction diagnosed using Hampton and Castleman criteria on CT.
  • Multivariable logistic regression analysis to identify predictors of infarction.

Main Results:

  • Pulmonary infarction prevalence was 31%.
  • Infarction patients were younger and had fewer cardiovascular diseases.
  • Risk factors included younger age, increasing height, and current smoking; increasing BMI showed a protective effect.

Conclusions:

  • Pulmonary infarction is common in acute PE, affecting nearly one-third of patients.
  • Infarction is more prevalent in younger, healthier individuals, with specific risk factors identified.
  • Height and smoking increase infarction risk, while BMI may offer protection.